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Updated: Oct 13, 2025
A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Impaired Microcirculation and Vascular Hemodynamics in Relation to Macrocirculation in Patients With Systemic Lupus
Christina Svensson1,2, Per Eriksson3, Niclas Bjarnegård2
1Department of Clinical Physiology, University Hospital, Linköping, Sweden.
Insights
Systemic lupus erythematosus (SLE) patients show impaired microcirculation and vascular hemodynamics, indicating early vascular damage. These findings, using novel methods, correlate with intima-media thickness and plaque presence, suggesting increased cardiovascular disease risk.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Vascular Biology
Background:
- Systemic lupus erythematosus (SLE) is linked to premature cardiovascular disease (CVD) and mortality.
- Traditional risk factors do not fully explain the elevated CVD risk in SLE patients.
- Microcirculatory and hemodynamic impairments may signal early vascular changes in SLE.
Purpose of the Study:
- To investigate if microcirculation and pulse wave analysis offer additional insights into early vascular disease in SLE compared to ultrasound alone.
- To evaluate microcirculatory oxygen saturation (OxyP) and central augmentation index (AIx75) in SLE patients.
- To correlate these parameters with ultrasound-assessed vascular parameters like intima-media thickness (IMT) and plaque occurrence.
Main Methods:
- Sixty SLE patients (categorized by lupus nephritis, antiphospholipid syndrome, or skin/joint involvement) and 60 controls were studied.
- Microcirculatory peak oxygen saturation (OxyP) was measured using laser Doppler flowmetry/diffuse reflectance spectroscopy.
- Pulse waves (AIx75) and vascular ultrasound (IMT, plaque) were assessed in carotid and central arteries.
Main Results:
- SLE patients exhibited lower OxyP and higher AIx75 compared to controls.
- OxyP and AIx75 correlated significantly with IMT in various arteries (carotid, femoral).
- Patients with arterial plaque had significantly lower OxyP and higher AIx75, indicating more severe vascular affection.
Conclusions:
- Impaired microcirculation and altered vessel hemodynamics are present in SLE patients.
- These vascular changes correlate with structural markers of atherosclerosis (IMT, plaque).
- Early detection of macro- and micro-circulatory dysfunction is crucial for assessing CVD risk in SLE.
Abstract:
Introduction: Systemic lupus erythematosus (SLE) is associated with premature cardiovascular disease (CVD) and mortality, unexplained by traditional risk factors. Impairment of microcirculation and vascular hemodynamics may represent early signs of vascular affection. We hypothesized that studies of microcirculation and pulse waves may provide additional information, compared to ultrasound (US) alone, for the detection of early vascular disease in SLE. Methods: Sixty well-characterized SLE-patients (52 women, eight men; mean age 43.21 ± 1.3 years) characterized by lupus nephritis (LN; n = 20), antiphospholipid syndrome (APS; n = 20) or skin and joint involvement (n = 20) and 60 healthy controls were included. Microcirculatory peak oxygen saturation (OxyP) was evaluated using a novel combined laser Doppler flowmetry/diffuse reflectance spectroscopy method. Pulse waves were recorded in the radial artery by the aid of applanation tonometry in order to calculate central augmentation index (AIx75). Intima-media thickness (IMT) and plaque occurrence were evaluated using high frequency US, in carotid and central arteries. Results: Lower OxyP (84 ± 8 vs. 87 ± 5 %, p = 0.01) and higher AIx75 (17.3 ± 13.9 vs. 10.0 ± 14.2 %, p = 0.005) were seen in the SLE cohort. OxyP was inversely correlated with IMT in internal carotid artery (ICA), (R = -0.32, p = 0.01). AIx75 correlated with IMT in common carotid artery (CCA), (R = 0.36, p = 0.005), common femoral artery (CFA), (R = 0.43, p = 0.001), and ICA (R = 0.27, p = 0.04). AIx75 correlated negatively with OxyP (R = -0.29, p = 0.02). SLE-patients with plaque had lower OxyP values (80 ± 8 vs. 85 ± 7 %, p < 0.001) and higher AIx75 (23.0 ± 11.6 vs. 15.5 ± 14.2 %, p < 0.001) compared to those without plaque. Conclusion: Impaired microcirculation and vessel hemodynamics were observed in SLE. These methods correlated with IMT and plaque occurrence. The importance of early macro- and micro-circulatory vascular affection for increased risk of CVD in SLE will be followed-up in future studies.
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